DOCSLIB.ORG

Guidelines for the Clinical Use of Radioactive Materials (RAM) and Radiation-Producing Machines (RPM)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Guidelines for the Clinical Use of Radioactive Materials (RAM) And Radiation-Producing Machines (RPM) CPM 122 This guideline is intended as a resource document for the safe use of radiation in the clinical setting. If you have questions or comments, please contact the Office of Radiation Safety at (414) 805-6540. Revised March 2013 1 Section I: General Policies page Management Policy Statement 2 Radiation Safety Program [CPM.0120] Radiation Safety Committee 3 Radiation Safety Office (RS) 3 Authorized User 4 Staff 4 Section II: Medical Use Operating Policies Medical Use of Radiation/Radioactive Materials 4 Medical Events [RSO-008] 5 Reports of Medical Events 6 Sentinel Events - Fluoroscopy [CPM.0124] 7 Radiation Therapy Inpatients [RSO-200] 7 Medical Emergency Procedures of an Inpatient Following Therapeutic Dose of Radionuclides or Implantation of Radiation Devices 9 Death of an Inpatient Following Therapeutic Dose of Radionuclides or Implantation of Radiation Devices [CPM.0160] 10 Release of Patients [CPM.0125] 15 Records 15 Monitoring Radiation Dose [CPM.0123] 15 Radiation Exposure During Pregnancy [CPM.0121] 16 Surveys and Monitoring 18 Radioactive Material, Receipt of [CPM.0165] 18 Posting Requirements 18 Storage and Security of RAM/RPM 20 Syringe and Vial Shields 20 Processing I-125 Radioactive Seeds [RSO-501] 20 Section III: Use of Diagnostic Medical X-Ray Equipment Use of Diagnostic Medical X-Ray Equipment [CPM.0119] 20 X-Ray Radiation Protection [CPM.0118] 21 Revised March 2013 2 Section I: General Policies Management Control and Responsibilities Management Policy Statement Radiation Safety Program [CPM.0120] The Medical College of Wisconsin (MCW) is licensed by the State of Wisconsin, Department of Health Services (DHS) to use radioactive materials (RAM) for clinical and research applications at facilities located at Froedtert Memorial Lutheran Hospital (FMLH) and MCW. The RAM license is a broadscope license for the use of unsealed and sealed sources for clinical human use and biomedical research including for the use of cobalt-60 as sealed sources in teletherapy irradiators, biomedical research and for the use of cesium-137 as sealed sources for use in self-shielded irradiators for the irradiation of materials, e.g., small animals, biological samples, blood and blood products, excluding explosive and flammable materials. The Administrations of MCW and FMLH are responsible for the maintenance of the license and the activities governed by DHS. FMLH and MCW are jointly responsible for the implementation and review of a radiation safety program that conforms to DHS regulations, specific license conditions and other federal, state and local regulating agencies. The radiation safety program is directed and monitored by the Radiation Safety Committee (RSC). The RSC is an administrative committee responsible for the oversight of RAM under the licenses. The day-to-day operation of the radiation safety program is provided by the Radiation Safety Office (RS) under the direction of the Radiation Safety Officer (RSO). The RSO has been delegated the authority by FMLH and MCW administrations to address and resolve problems that could lead to noncompliance of regulations or DHS license conditions. The RSO is a member of the FMLH Environment of Care Committee for purposes of reporting and coordinating safety and emergency response activity. Radiation Safety Committee (RSC) The RSC is comprised of, but not limited to, the RSO, representatives from the administrations of FH and MCW, an authorized user from each type of use permitted under the license, a representative of the nursing service and ad hoc members deemed appropriate by the administration. The responsibilities of the RSC regarding the use of radioactive material (RAM) are to establish policies and procedures for the use of RAM at the facilities under the license approve or deny applications for the use of RAM and review the radiation safety program with the assistance of the RSO. Radiation Safety Office (RS) The day-to-day operation of the radiation safety program is conducted by the RS staff. The RSO oversees the RS and staff. The duties of the staff include monitoring RAM use, identifying radiation safety problems, verifying implementation of corrective actions and monitoring compliance with regulations. Revised March 2013 3 Additionally, the RS initiates, recommends, and/or provides corrective actions for areas of concern, and occurrences of noncompliance with DHS regulations or license conditions. The RS, under the supervision of the RSO, is delegated the authority necessary to assure the radiation safety requirements are met, including the stoppage of any operation deemed unsafe. Authorized User The medical use of radiation, either RAM or RPM, shall only be with the knowledge and approval of the RSC. Applications for such use shall be submitted to the RS for review by the RSC. An applicant shall be a physician licensed to practice medicine in the state of Wisconsin and meet the training criteria designated by Wisconsin Administrative Code, DHS 157. Staff Individuals who come into contact with RAM or ionizing radiation from RAM and/or RPM have certain rights and responsibilities according to state and federal regulations. These are outlined in the DHS Form PPH 45027 - Notice to Employees, and the accompanying Supplement to Notice to Employees. These documents are posted in locations where RAM and RPM are used or stored. Section II: Medical Use Operating Policies Medical Use of Radiation/Radioactive Materials The RSC shall approve authorized user physicians for medical use of RAM for diagnosis or therapy, and the therapeutic use of radiation (e.g., external beam teletherapy). Applicants must provide documentation of training and experience qualifications prior to approval by the RSC. The use of radiation-emitting products in a manner other than that specified in the Registry of Sealed Sources and Devices requires approval from the appropriate Institutional Review Board (IRB). All references in this manual to the term ‘patient’ refers to the patient or human research subject as referenced to in DHS 157. The medical use of radionuclides/radiation in procedures not requiring a written directive shall be performed in such a manner as to maintain radiation exposure to employees and the public as low as reasonably achievable and in accordance with DHS regulations, license conditions, and the departmental Policy and Procedure manual. The medical use of RAM/RPM requiring a written directive shall be performed in accordance with the written directive and in such a manner as to maintain radiation exposure to employees and the public as low as reasonably achievable. Specifically, radiation levels shall be maintained such that individual members of the public could not receive a radiation dose in excess of 0.02 mSv (2 mrem) in any one hour or 1 mSv (100 mrem) in one year. Patients having been administered doses of unsealed RAM or radioactive implants shall not be released from control unless the total effective dose equivalent to any individual member of the public from exposure to the released Revised March 2013 4 individual is not likely to exceed 5 mSv (500 mrem). Release of such patients shall be in accordance with DHS 157.62(8). Medical Events [RSO-008] Medical events are defined in DHS 157.72(1) for RAM and DHS 157.83(3) for RPM. A brief description is listed below, for full requirements; refer to the appropriate section of the DHS regulations: 1. A dose that differs from the prescribed dose or dose that would have resulted from the prescribed dosage by more than 50 mSv (5 rem) effective dose equivalent, 500 mSv (50 rem) to an organ or tissue, or 500 mSv (50 rem) shallow dose equivalent to the skin; and a. The total dose delivered differs from the prescribed dose by 20 percent or more; b. The total dosage delivered differs from the prescribed dosage by 20 percent or more or falls outside the prescribed dosage range; or c. The fractionated dose delivered differs from the prescribed dose, for a single fraction, by 50 percent or more. 2. A dose that exceeds 50 mSv (5 rem) effective dose equivalent, 500 mSv (50 rem) to an organ or tissue, or 500 mSv (50 rem) shallow dose equivalent to the skin from any of the following-- a. An administration of a wrong radioactive drug containing RAM; b. An administration of a radioactive drug containing RAM by the wrong route of administration; c. An administration of a dose or dosage to the wrong individual or human research subject; d. An administration of a dose or dosage delivered by the wrong mode of treatment; or e. A leaking sealed source. 3. A dose to the skin or an organ or tissue other than the treatment site that exceeds by 500 mSv (50 rem) to an organ or tissue and 50 percent or more of the dose expected from the administration defined in the written directive (excluding, for permanent implants, seeds that were implanted in the correct site but migrated outside the treatment site). 4. Any event resulting from intervention of a patient in which the administration of RAM or radiation results or will result in unintended permanent functional damage to an organ or a physiological system, as determined by a physician, shall be reported in the same manner as a medical event. Any individual who knows of or suspects any occurrences that may meet the criteria listed above shall report such occurrences promptly to their immediate supervisor, the authorized user, Revised March 2013 5 authorized medical physicist, authorized nuclear pharmacist, or a radiation safety staff member, as appropriate. Such occurrences shall be evaluated as potential medical events. Reports of Medical Events In general, reports of medical events shall be made by the RSO or designee after consultation with the authorized user and authorized medical physicist/nuclear pharmacist, and a determination is made that an occurrence may constitute a medical event.
Recommended publications
  • Submission to the Nuclear Power Debate Personal Details Kept Confidential

    Submission to the Nuclear Power Debate Personal Details Kept Confidential

    Submission to the Nuclear power debate Personal details kept confidential __________________________________________________________________________________________ Firstly I wish to say I have very little experience in nuclear energy but am well versed in the renewable energy one. What we need is a sound rational debate on the future energy requirements of Australia. The calls for cessation of nuclear investigations even before a debate begins clearly shows that emotion rather than facts are playing a part in trying to stop the debate. Future energy needs must be compliant to a sound strategy of consistent, persistent energy supply. This cannot come from wind or solar. Lets say for example a large blocking high pressure weather system sits over the Victorian, NSW land masses in late summer- autumn season. We will see low winds for anything up to a week, can the energy market from the other states support the energy needs of these states without coal or gas? I think not. France has a large investment in nuclear energy and charges their citizens around half as much for it than Germany. Sceptics complain about the costs of storage of waste, they do not suggest what is going to happen to all the costs to the environment when renewing of derelict solar panels and wind turbine infrastructure which is already reaching its use by dates. Sceptics also talk about the dangers of nuclear energy using Chernobyl, Three Mile Island and Fuklushima as examples. My goodness given that same rationale then we should have banned flight after the first plane accident or cars after the first car accident.
  • NUREG-1350, Vol. 31, Information

    NUREG-1350, Vol. 31, Information

    NRC Figure 31. Moisture Density Guage Bioshield Gauge Surface Detectors Depth Radiation Source GLOSSARY 159 GLOSSARY Glossary (Abbreviations, Definitions, and Illustrations) Advanced reactors Reactors that differ from today’s reactors primarily by their use of inert gases, molten salt mixtures, or liquid metals to cool the reactor core. Advanced reactors can also consider fuel materials and designs that differ radically from today’s enriched-uranium dioxide pellets within zirconium cladding. Agreement State A U.S. State that has signed an agreement with the U.S. Nuclear Regulatory Commission (NRC) authorizing the State to regulate certain uses of radioactive materials within the State. Atomic energy The energy that is released through a nuclear reaction or radioactive decay process. One kind of nuclear reaction is fission, which occurs in a nuclear reactor and releases energy, usually in the form of heat and radiation. In a nuclear power plant, this heat is used to boil water to produce steam that can be used to drive large turbines. The turbines drive generators to produce electrical power. NUCLEUS FRAGMENT Nuclear Reaction NUCLEUS NEW NEUTRON NEUTRON Background radiation The natural radiation that is always present in the environment. It includes cosmic radiation that comes from the sun and stars, terrestrial radiation that comes from the Earth, and internal radiation that exists in all living things and enters organisms by ingestion or inhalation. The typical average individual exposure in the United States from natural background sources is about 310 millirem (3.1 millisievert) per year. 160 8 GLOSSARY 8 Boiling-water reactor (BWR) A nuclear reactor in which water is boiled using heat released from fission.
  • Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center

    Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center

    DEPARTMENT OF HEALTH & HUMAN SERVICES OFFICE OF INSPECTOR GENERAL Office of Audit Services, Region IV 61 Forsyth Street, SW, Suite 3T41 Atlanta, GA 30303 February 6, 2012 Report Number: A-04-11-06135 Ms. Suzanne Freeman Divisional President Carolinas Medical Center P.O. Box 32861 Charlotte, NC 28232-2861 Dear Ms. Freeman: Enclosed is the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG), final report entitled Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center. We will forward a copy of this report to the HHS action official noted on the following page for review and any action deemed necessary. The HHS action official will make final determination as to actions taken on all matters reported. We request that you respond to this official within 30 days from the date of this letter. Your response should present any comments or additional information that you believe may have a bearing on the final determination. Section 8L of the Inspector General Act, 5 U.S.C. App., requires that OIG post its publicly available reports on the OIG Web site. Accordingly, this report will be posted at http://oig.hhs.gov. If you have any questions or comments about this report, please do not hesitate to call me, or contact Andrew Funtal, Audit Manager, at (404) 562-7762 or through email at [email protected]. Please refer to report number A-04-11-06135 in all correspondence. Sincerely, /Lori S. Pilcher/ Regional Inspector General for Audit Services Enclosure Page 2 – Ms. Suzanne Freeman Direct Reply to HHS Action Official: Nanette Foster Reilly Consortium Administrator Consortium for Financial Management & Fee for Service Operations Centers for Medicare & Medicaid Services 601 East 12th Street, Room 235 Kansas City, Missouri 64106 Department of Health and Human Services OFFICE OF INSPECTOR GENERAL REVIEW OF OUTPATIENT BRACHYTHERAPY MEDICARE PAYMENTS TO CAROLINAS MEDICAL CENTER Daniel R.
  • Radiation Quick Reference Guide Recommend Contacting Your State Fusion Center

    Radiation Quick Reference Guide Recommend Contacting Your State Fusion Center

    Domestic Nuclear Detection Office If you encounter something suspicious follow your specific local protocols. Radiation Quick Reference Guide Recommend contacting your state fusion center. DNDO is available 24/7 to assist at 1-877-DNDO-JAC / 1-877-363-6522 JAC Information Line 202-254-7179 Email: [email protected] Nuclear Concerns/ Threats 1. Nuclear Weapon - a device that releases nuclear energy in an ex- Isotopes of Concern for use in RDDs - with common uses plosive manner. Uses Highly Enriched Uranium (HEU) and/or 1. Cobalt-60 – cancer treatment, level/ Plutonium. density gauge, teletherapy, radiography, 2. Improvised Nuclear Device (IND) - a nuclear weapon fabricated food sterilization/irradiation, by a terrorist organization or rogue nation. brachytherapy 2. Iridium-192 – Radiography/non- destructive testing, flaw detection, brachy- therapy “cancer seed”, skin cancer Cobalt 60 sources Uranium “superficial” brachytherapy Plutonium 3. Uranium a. Uranium exists naturally in the earth’s crust. Of the different “isotopes” of uranium, U-235 is the one required to produce a Iridium sentinel and nuclear weapon. gamma camera b. Natural uranium contains a small amount of U-235 (<1%) which Cesium Seeds must be separated in complex extraction processes to create HEU. The predominant uranium isotope is U-238. 3. Cesium-137 - Gauge/level gauge, industrial radiography, brachyther- c. Highly Enriched Uranium (HEU) refers to uranium usable in weap- apy/teletherapy, well logging/density gauges ons due to its enrichment in U-235. 4. Strontium-90 – Radioisotope thermoelectric generator (RTG), fis- d. Approximately 25 kg of HEU is required for a nuclear weapon. sion product, industrial gauges, medical treatment e.
  • HISTORY Nuclear Medicine Begins with a Boa Constrictor

    HISTORY Nuclear Medicine Begins with a Boa Constrictor

    HISTORY Nuclear Medicine Begins with a Boa Constrictor Marshal! Brucer J Nucl Med 19: 581-598, 1978 In the beginning, a boa constrictor defecated in and then analyzed the insoluble precipitate. Just as London and the subsequent development of nuclear he suspected, it was almost pure (90.16%) uric medicine was inevitable. It took a little time, but the acid. As a thorough scientist he also determined the 139-yr chain of cause and effect that followed was "proportional number" of 37.5 for urea. ("Propor­ inexorable (7). tional" or "equivalent" weight was the current termi­ One June week in 1815 an exotic animal exhibi­ nology for what we now call "atomic weight.") This tion was held on the Strand in London. A young 37.5 would be used by Friedrich Woehler in his "animal chemist" named William Prout (we would famous 1828 paper on the synthesis of urea. Thus now call him a clinical pathologist) attended this Prout, already the father of clinical pathology, be­ scientific event of the year. While he was viewing a came the grandfather of organic chemistry. boa constrictor recently captured in South America, [Prout was also the first man to use iodine (2 yr the animal defecated and Prout was amazed by what after its discovery in 1814) in the treatment of thy­ he saw. The physiological incident was common­ roid goiter. He considered his greatest success the place, but he was the only person alive who could discovery of muriatic acid, inorganic HC1, in human recognize the material. Just a year earlier he had gastric juice.
  • The Supply of Medical Isotopes

    The Supply of Medical Isotopes

    The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS The Supply of Medical Isotopes AN ECONOMIC DIAGNOSIS AND POSSIBLE SOLUTIONS This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of OECD member countries. This document, as well as any data and any map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Please cite this publication as: OECD/NEA (2019), The Supply of Medical Isotopes: An Economic Diagnosis and Possible Solutions, OECD Publishing, Paris, https://doi.org/10.1787/9b326195-en. ISBN 978-92-64-94550-0 (print) ISBN 978-92-64-62509-9 (pdf) The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Photo credits: Cover © Yok_onepiece/Shutterstock.com. Corrigenda to OECD publications may be found on line at: www.oecd.org/about/publishing/corrigenda.htm. © OECD 2019 You can copy, download or print OECD content for your own use, and you can include excerpts from OECD publications, databases and multimedia products in your own documents, presentations, blogs, websites and teaching materials, provided that suitable acknowledgement of OECD as source and copyright owner is given.
  • Radiation and Risk: Expert Perspectives Radiation and Risk: Expert Perspectives SP001-1

    Radiation and Risk: Expert Perspectives Radiation and Risk: Expert Perspectives SP001-1

    Radiation and Risk: Expert Perspectives Radiation and Risk: Expert Perspectives SP001-1 Published by Health Physics Society 1313 Dolley Madison Blvd. Suite 402 McLean, VA 22101 Disclaimer Statements and opinions expressed in publications of the Health Physics Society or in presentations given during its regular meetings are those of the author(s) and do not necessarily reflect the official position of the Health Physics Society, the editors, or the organizations with which the authors are affiliated. The editor(s), publisher, and Society disclaim any responsibility or liability for such material and do not guarantee, warrant, or endorse any product or service mentioned. Official positions of the Society are established only by its Board of Directors. Copyright © 2017 by the Health Physics Society All rights reserved. No part of this publication may be reproduced or distributed in any form, in an electronic retrieval system or otherwise, without prior written permission of the publisher. Printed in the United States of America SP001-1, revised 2017 Radiation and Risk: Expert Perspectives Table of Contents Foreword……………………………………………………………………………………………………………... 2 A Primer on Ionizing Radiation……………………………………………………………………………... 6 Growing Importance of Nuclear Technology in Medicine……………………………………….. 16 Distinguishing Risk: Use and Overuse of Radiation in Medicine………………………………. 22 Nuclear Energy: The Environmental Context…………………………………………………………. 27 Nuclear Power in the United States: Safety, Emergency Response Planning, and Continuous Learning…………………………………………………………………………………………….. 33 Radiation Risk: Used Nuclear Fuel and Radioactive Waste Disposal………………………... 42 Radiation Risk: Communicating to the Public………………………………………………………… 45 After Fukushima: Implications for Public Policy and Communications……………………. 51 Appendix 1: Radiation Units and Measurements……………………………………………………. 57 Appendix 2: Half-Life of Some Radionuclides…………………………………………………………. 58 Bernard L.
  • Radioactive Waste

    Radioactive Waste

    Radioactive Waste 07/05/2011 1 Regulations 2 Regulations 1. Nuclear Regulatory Commission (NRC) 10 CFR 20 Subpart K. Various approved options for radioactive waste disposal. (See also Appendix F) 10 CFR 35.92. Decay in storage of medically used byproduct material. 10 CFR 60. Disposal of high-level wastes in geologic repositories. 10 CFR 61. Shallow land disposal of low level waste. 10 CFR 62. Criteria and procedures for emergency access to non-Federal and regional low-level waste disposal facilities. 10 CFR 63. Disposal of high-level rad waste at Yucca Mountain, NV 10 CFR 71 Subpart H. Quality assurance for waste packaging and transportation. 10 CFR 72. High level waste storage at an MRS 3 Regulations 2. Department of Energy (DOE) DOE Order 435.1 Radioactive Waste Management. General Requirements regarding radioactive waste. 10 CFR 960. General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. Site selection guidelines for a waste repository. The following are not regulations but they provide guidance regarding the implementation of DOE Order 435.1: DOE Manual 435.1-1. Radioactive Waste Management Manual. Describes the requirements and establishes specific responsibilities for implementing DOE O 435.1. DOE Guide 435.1-1. Suggestions and acceptable ways of implementing DOE M 435.1-1 4 Regulations 3. Environmental Protection Agency 40 CFR 191. Environmental Standards for the Disposal of Spent Nuclear Fuel, High-level and Transuranic Radioactive Wastes. Protection for the public over the next 10,000 years from the disposal of high-level and transuranic wastes. 4. Department of Transportation 49 CFR Parts 171 to 177.
  • Brachytherapy with Miniature Electronic X-Ray Sources

    Brachytherapy with Miniature Electronic X-Ray Sources

    Brachytherapy with Miniature Electronic X-ray Sources Mark J. Rivard, Larry A. DeWerd, and Heather D. Zinkin Tufts-New England Medical Center, Boston, MA University of Wisconsin, Madison, WI DISCLOSURE Dr. Rivard serves as a consultant and Dr. DeWerd receives research support from Xoft, Inc. HISTORY Electronic brachytherapy (eBx) applies interstitial irradiation without radionuclides A miniature x-ray tube is commonly employed eBx conceived in the 1980s by Alan Sliski of PhotoElectron Corp. in collaboration with MIT Dosimetric properties and source characteristics first published in 1993 (Biggs et al., Gall et al., Smith et al.) in Medical Physics ~ 10 other companies pursued eBx since then RATIONALE Bx Source Advantages Disadvantages radionuclide Well established therapeutic use Fixed dosimetry properties Well established calibration procedures Radioactive waste concerns Fixed photon spectrum and half-life Regular source shipments due to decay High specific activity, small size electronic User-adjustable dose rate (on/off) Unproven clinical application User-adjustable dosimetric properties No NIST calibration protocol Lessened radiological exposure to staff Output variability amongst sources Typically larger in size No statements may be made at this time regarding cost differences or clinical results VENDOR SCOPE 1. Advanced X-ray Technologies Inc. Birmingham, MI 2. Carl Zeiss Ltd. Oberkochen, Germany 3. Xoft Inc. Fremont, CA Advanced X-ray Technologies Use of a primary and secondary targeting system with substantial polar and azimuthal
  • Fission-Produced 99Mo Without a Nuclear Reactor

    Fission-Produced 99Mo Without a Nuclear Reactor

    BRIEF COMMUNICATIONS Fission-Produced 99Mo Without a Nuclear Reactor Amanda J. Youker, Sergey D. Chemerisov, Peter Tkac, Michael Kalensky, Thad A. Heltemes, David A. Rotsch, George F. Vandegrift, John F. Krebs, Vakho Makarashvili, and Dominique C. Stepinski Argonne National Laboratory, Nuclear Engineering Division, Argonne, Illinois halted in the past due to inclement weather, natural phenomena, 99Mo, the parent of the widely used medical isotope 99mTc, is cur- flight delays, and terrorist threats (6). rently produced by irradiation of enriched uranium in nuclear reac- The predominant global 99Mo production route is irradiation of tors. The supply of this isotope is encumbered by the aging of these highly enriched uranium (HEU, $20% 235U) solid targets in nuclear reactors and concerns about international transportation and nu- reactors fueled by uranium (2). Other potential 99Mo production Methods: clear proliferation. We report results for the production paths include (n,g)98Mo and (g,n)100Mo; however, both routes re- of 99Mo from the accelerator-driven subcritical fission of an aqueous quire enriched molybdenum material and produce low-specific- solution containing low enriched uranium. The predominately fast 99 neutrons generated by impinging high-energy electrons onto a tan- activity Mo, which cannot be loaded directly on a commercial 99m talum convertor are moderated to thermal energies to increase fission Tc generator. The U.S. National Nuclear Security Administra- processes. The separation, recovery, and purification of 99Mo were tion implements the long-standing U.S. policy to minimize and demonstrated using a recycled uranyl sulfate solution. Conclusion: eliminate HEU in civilian applications by working to convert re- The 99Mo yield and purity were found to be unaffected by reuse of the search reactors and medical isotope production facilities to low previously irradiated and processed uranyl sulfate solution.
  • Nuclear Fusion Enhances Cancer Cell Killing Efficacy in a Protontherapy Model

    Nuclear Fusion Enhances Cancer Cell Killing Efficacy in a Protontherapy Model

    Nuclear fusion enhances cancer cell killing efficacy in a protontherapy model GAP Cirrone*, L Manti, D Margarone, L Giuffrida, A. Picciotto, G. Cuttone, G. Korn, V. Marchese, G. Milluzzo, G. Petringa, F. Perozziello, F. Romano, V. Scuderi * Corresponding author Abstract Protontherapy is hadrontherapy’s fastest-growing modality and a pillar in the battle against cancer. Hadrontherapy’s superiority lies in its inverted depth-dose profile, hence tumour-confined irradiation. Protons, however, lack distinct radiobiological advantages over photons or electrons. Higher LET (Linear Energy Transfer) 12C-ions can overcome cancer radioresistance: DNA lesion complexity increases with LET, resulting in efficient cell killing, i.e. higher Relative Biological Effectiveness (RBE). However, economic and radiobiological issues hamper 12C-ion clinical amenability. Thus, enhancing proton RBE is desirable. To this end, we exploited the p + 11Bà3a reaction to generate high-LET alpha particles with a clinical proton beam. To maximize the reaction rate, we used sodium borocaptate (BSH) with natural boron content. Boron-Neutron Capture Therapy (BNCT) uses 10B-enriched BSH for neutron irradiation-triggered alpha-particles. We recorded significantly increased cellular lethality and chromosome aberration complexity. A strategy combining protontherapy’s ballistic precision with the higher RBE promised by BNCT and 12C-ion therapy is thus demonstrated. 1 The urgent need for radical radiotherapy research to achieve improved tumour control in the context of reducing the risk of normal tissue toxicity and late-occurring sequelae, has driven the fast- growing development of cancer treatment by accelerated beams of charged particles (hadrontherapy) in recent decades (1). This appears to be particularly true for protontherapy, which has emerged as the most-rapidly expanding hadrontherapy approach, totalling over 100,000 patients treated thus far worldwide (2).
  • Review White Paper (Pdf)

    Review White Paper (Pdf)

    Brachytherapy: high precision, targeted radiotherapy Because life is for living Table of contents Executive summary 3 Introduction 4 Radiotherapy: present and future goals 5 Overview of brachytherapy 6 • Brachytherapy: high precision, targeted radiotherapy 6 Types of brachytherapy 7 Brachytherapy dosing 7 Brachytherapy efficacy and safety outcomes; patient benefits 8 • Brachytherapy in gynecological cancer 8 • Brachytherapy in prostate cancer 9 • Brachytherapy in breast cancer 12 • Brachytherapy in other cancers 14 • Brachytherapy in palliative care 15 Brachytherapy: setting benchmarks in radiation technology 15 • Advantages: technical and cost base 15 • Ongoing advances in brachytherapy result in improved outcomes and efficiency 16 Cost effectiveness: making efficient use of healthcare resources 17 Conclusions 19 Glossary 20 References 21 2 Brachytherapy: high precision, targeted radiotherapy Executive summary Radiotherapy is a key cornerstone of cancer care: this • The ability of brachytherapy to deliver high radiation White Paper reviews the role of brachytherapy – high doses over a short time period means patients can precision, targeted radiotherapy – in cancer treatment, complete treatment in days rather than the and discusses how it offers an effective, well tolerated weeks required for EBRT. For example, high dose rate radiation treatment option, tailored to the needs and (HDR) brachytherapy treatment for prostate cancer preferences of the individual patient. can be delivered in two treatment sessions, compared to several weeks with EBRT. This has important Brachytherapy combines two fundamental aims potential implications for patient compliance with of radiotherapy: an effective tumor dose with their radiotherapy treatment, as well as minimizing sparing of the surrounding tissue. Brachytherapy is impact on patients’ lives at the forefront of innovation in radiotherapy.